微通道经皮肾镜与输尿管软镜碎石取石术对输尿管上段结石患者血液流变学及男性性功能指标的影响

摘要 目的：以血液流变学及男性性功能指标为主要观察指标分析微通道经皮肾镜取石术（MPCNL）与输尿管软镜碎石取石术（FURL）在输尿管上段结石（UUC）中的应用价值。方法：将80例男性UUC患者按简单随机化法分MPCNL组、FURL组各40例；比较两组清石率、血液流变学、性功能指标及不良反应。结果：两组术后1w（82.50% vs 85.00%）、术后1mo（92.50% vs 97.50%）、术后3mo（100.00% vs 100.00%）的清石率无统计学意义（P＞0.05）。FURL组术后1天、术后7天的血液流变学指标水平均低于MPCNL组（P＜0.05）。两组术后男性性功能指标较术前显著改善，但FURL组术后3mo、6mo的男性性功能指标改善更显著（P＜0.05）。结论：对于UUC患者，MPCNL和FURL均能有效清除结石，都是安全有效的方法，但FURL较MPCNL对患者术后血液流变学的影响更小，且更利于术后性功能的恢复。

Effects of Minimally Invasive Percutaneous Nephrolithotomy and Flexible Ureteroscopic Lithotripsy on Hemorheology and Sexual Function Indicators in Male Patients with Upper Ureteral Calculi

ABSTRACT Objective: To analyze the application value of minimally invasive percutaneous nephrolithotomy (MPCNL) and flexible ureteroscopic lithotripsy (FURL) in upper ureteral calculi (UUC) based on hemorheology and sexual function indicators. Methods: Eighty male patients with UUC were randomized into MPCNL group and FURL group, 40 cases in each. The two groups were compared on stone clearance rate, hemorheology, sexual function indicators, and adverse reactions. Results: The stone clearance rates in the two groups at 1w, 1mo and 3mo after operation were close(P>0.05). The levels of hemorheological indicators on day 1 and day 7 after operation were lower in FURL group than in MPCNL group(P<0.05). The sexual function indicators in the two groups were significantly improved after operation. The improvement at 3 and 6 months after operation was more significant in FURL group (P<0.05). Conclusion: For patients with UUC, both MPCNL and FURL are safe and effective to remove the stones. However, the latter has less influence on postoperative hemorheology, and is more beneficial to postoperative sexual function recovery.